探讨VEGF在妊娠期糖尿病胎盘组织中的表达及其对新生儿神经行为的影响

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目的探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)在妊娠期糖尿病(gestational diabetesmellitus,GDM)胎盘组织中的表达以及其与GDM胎盘病理改变、新生儿神经行为的关系。方法在妊娠期糖尿病孕妇中,按分娩前血糖值的高低选取血糖控制欠佳的孕妇50例为控制欠佳组和选取血糖控制较好的孕妇50例为控制较好组,正常妊娠孕妇50例为对照组。于胎儿、胎盘娩出后,在胎盘的中央带取材,经固定、脱水、包埋、切片后,行VEGF免疫组织化学染色。新生儿行头颅超声检查,并作新生儿神经行为评分。结果 VEGF在GDM血糖控制欠佳组胎盘中表达阳性率明显高于正常对照组(84.6%vs30.6%,P<0.01);而血糖控制较好组的VEGF阳性表达率与对照组比较无统计学意义。VEGF在胎盘呈高阳性表达率所分娩的新生儿行神经行为评分低于VEGF呈低表达率所分娩的新生儿,P<0.01;VEGF在胎盘呈高阳性表达率所分娩的新生儿头颅超声发现室管膜下囊性改变、脉络丛囊性改变等异常的机率升高,与对照组相比P<0.01。结论 GDM孕妇血糖控制欠佳时,VFGF在胎盘组织中呈高阳性率表达,所分娩的新生儿,神经行为评分欠理想,陈旧性颅内出血的发生率升高。 Objective To investigate the expression of vascular endothelial growth factor (VEGF) in placenta of gestational diabetes mellitus (GDM) and its relationship with pathological changes of GDM placenta and neurological behavior of newborn. Methods Pregnant women with gestational diabetes mellitus were selected according to the level of blood glucose before delivery. Fifty pregnant women with poorly controlled blood glucose were selected as the control group and 50 healthy pregnant women with better glycemic control as control group. Fifty pregnant women with normal pregnancy For the control group. In the fetus, after the placenta was delivered, the placenta was taken from the center of the placenta, fixed, dehydrated, embedded and sectioned for VEGF immunohistochemical staining. Neonatal skull ultrasound examination and neonatal neurobehavioral score. Results The positive rate of VEGF expression in the placenta with poor glycemic control was significantly higher than that in the control group (84.6% vs 30.6%, P <0.01). However, the positive rate of VEGF expression in the group with good glycemic control was not statistically different from that in the control group Significance of learning. Neonates delivered by VEGF at a high positive rate in the placenta had a lower neurological score than those born at a low rate of VEGF expression (P <0.01), and newborns with high positive rates of VEGF expressed in the placenta Subependymal cystic changes, changes in choroid plexus and other abnormalities increased the probability of P <0.01 compared with the control group. Conclusions In poor GDM control, the expression of VFGF is highly positive in placenta. The newborn infants born with GDM have unsatisfactory neurobehavioral scores and an increased incidence of old intracranial hemorrhage.
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